title: Endobronchial closure of a bronchopleural fistula using a fibrin glue-coated collagen patch and fibrin glue.
abstract: Bronchopleural fistulas associated with empyema can occur as life-threatening sequelae after pulmonary resection, occurring most frequently after pneumonectomy. Three bronchopleural fistulas, 5-6 mm in diameter, were successfully treated using a fibrin glue-coated collagen patch (FGCCP) and fibrin glue (FG) at the site of a bronchopleural fistula. Through the clinical experiences, we introduce the methodology to perform the endobronchial closure of bronchopleural fistulas.Data were collected by reviewing the clinical charts of patients diagnosed with post-lobectomy bronchopleural fistula at Sapporo Minami-Sanjo Hospital from June 2004 to December 2010. Bronchopleural fistula was diagnosed by means of endoscopic visualization. Three cases of post-lobectomy and one case of post-pneumonectomy bronchopleural fistula were collected.A FGCCP fragment was packed within the fistula, and the fragment grasped with the forceps was kept in this position for approximately a minute, a time during which a FGCCP becomes adhesive, and the patch fragment was released. After releasing the patch fragment, the FG was applied directly on the FGCCP using a two-channel catheter.There have been few reports of the bronchoscopic closure of bronchopleural fistulas using a FGCCP and FG. Closure of small bronchopleural fistulas with the application of a FGCCP and FG may offer a valuable therapeutic alternative.
authors.affiliation: Department of Thoracic Surgery, Sapporo Minami-Sanjo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Keidai
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kato
authors.forename: Masato
authors.initials: M
authors.lastname: Aragaki
authors.forename: Ryunosuke
authors.initials: R
authors.lastname: Hase
authors.forename: Toyohiro
authors.initials: T
authors.lastname: Saikai
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
authors.forename: Mitsuhito
authors.initials: M
authors.lastname: Kaji
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D001983:Bronchial Fistula / Q000628:therapy*; D001999:Bronchoscopy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003094:Collagen / Q000627:therapeutic use*; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D003094:Collagen